Sublobar resections in stage IA non-small cell lung cancer: segmentectomies result in significantly better cancer-related survival than wedge resections☆

Sienel, Wulf; Dango, Sebastian; Kirschbaum, Andreas; Cucuruz, Beatrix; Hörth, Wolfram; Stremmel, Christian; Passlick, Bernward

doi:10.1016/j.ejcts.2007.12.048

Cited by 173 publications

(120 citation statements)

References 17 publications

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“…Two reports present retrospective comparisons of segmentectomy and wedge resection [43,44]. The report by EL-SHERIF et al [43] focuses on the relationship between resection margin and local recurrence in patients with stage I nonsmall cell lung cancer who underwent either segmentectomy or wedge resection.…”

Section: Segmentectomy Versus Wedge Resectionmentioning

confidence: 99%

“…In the series of EL-SHERIF et al [43], resection margins had no impact on regional or distant recurrence. In the study of SIENEL et al [44], 56 patients underwent segmentectomy with systematic nodal dissection and 31 underwent wedge resection with selective nodal sampling at the surgeon's discretion for stage I nonsmall cell lung cancer. Sublobar resections were indicated because of cardiopulmonary impairment.…”

Section: Segmentectomy Versus Wedge Resectionmentioning

confidence: 99%

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Sublobar resection for lung cancer

Rami–Porta

Tsuboi²

2009

Eur Respir J

102

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Sublobar resection for small lung cancers has been debated frequently and is still a controversial issue. The only randomised trial comparing lobectomy with sublobar resections found a significantly higher recurrence rate for the latter, but failed to show significant differences in survival, although survival was better for the lobectomy group. One meta-analysis and several nonrandomised comparisons have confirmed these results. In general, lobectomy and sublobar resections have similar 5-yr survival rates. Local recurrence after wedge resection is higher than after segmentectomy. However, for patients aged .71 yrs, lobectomy and wedge resection are associated with similar survival. For tumours of f2 cm, segmentectomy is equivalent to lobectomy, but survival after segmentectomy is worse if performed for larger tumours. For both segmentectomy and wedge resection, tumour margins should be o1 cm wide to avoid recurrence. For pure bronchioloalveolar carcinoma of f2 cm, diagnosed intraoperatively with certainty, sublobar resection seems equivalent to lobectomy, and because there is no nodal involvement, systematic nodal dissection may not be necessary. In case of doubt, however, lobectomy with systematic nodal dissection will ensure complete resection and adequate staging. More randomised trials are needed to confirm all these issues.

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Section: Segmentectomy Versus Wedge Resectionmentioning

confidence: 99%

Section: Segmentectomy Versus Wedge Resectionmentioning

confidence: 99%

Sublobar resection for lung cancer

Rami–Porta

Tsuboi²

2009

Eur Respir J

102

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“…There are several facts that may explain this worse prognosis. Segmentectomies are associated with a significant better cancer-related survival than that of wedge resections in patients with stage IA tumours, even when the subgroup of tumours ≤2 cm in size is analysed independently; and recurrence is significantly lower for segmentectomies (12). Recurrence is significantly higher when the resection margin is <1 cm and this is found more frequently in wedge resections than in segmentectomies (13).…”

mentioning

confidence: 83%

“…Recurrence is significantly higher when the resection margin is <1 cm and this is found more frequently in wedge resections than in segmentectomies (13). This may be because other sites of field cancerization in the same lobe are not included in the resected specimen, to STAS, as described above, or to suboptimal intraoperative nodal assessment, which tends to be more limited in wedge resections (12). There is no doubt that segmentectomies and wedge resections are different operations that we tend to put together in the same box.…”

mentioning

confidence: 87%

Tiny lung adenocarcinomas: better prognosis with a word of caution

Rami‐Porta

2016

J. Thorac. Dis.

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“…In these trials, selection for limited resection includes tumors 2 cm or less in size, peripheral tumors close to the outer third of the lung and good functional status. Finally, sub-lobar resection should preferably be performed by a segment and not by a wedge resection as current data in early stage NSCLC patients revealed that a segment resection is associated with a higher cancer-related survival and lower local recurrence rate compared with a wedge resection [36] .…”

Section: Nsclc Stagementioning

confidence: 99%

Surgical strategies in the therapy of non-small cell lung cancer

Al-Shahrabani

Vallböhmer

Angenendt

et al. 2014

WJCO

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Lung cancer represents the leading cause of cancer mortality worldwide. Despite improvements in preoperative staging, surgical techniques, neoadjuvant/adjuvant options and postoperative care, there are still major difficulties in significantly improving survival, especially in locally advanced non-small cell lung cancer (NSCLC). To date, surgical resection is the primary mode of treatment for stage Ⅰ and Ⅱ NSCLC and has become an important component of the multimodality therapy of even more advanced disease with a curative intention. In fact, in NSCLC patients with solitary distant metastases, surgical interventions have been discussed in the last years. Accordingly, this review displays the recent surgical strategies implemented in the therapy of NSCLC patients. Key words: Non-small cell lung cancer; Multimodality therapy; Surgical techniques; Neoadjuvant/adjuvant therapy; Solitary distant metastases Core tip: Lung cancer represents the leading cause of cancer mortality worldwide. To date, surgical resection is the primary mode of treatment for stage Ⅰ and Ⅱ non-small cell lung cancer (NSCLC) and has become an important component of the multimodality therapy of even more advanced disease with a curative intention. In fact, individualized treatment options, based on clinical tumor stages, in NSCLC patients have been established in the last years that are displayed in this review.

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Sublobar resections in stage IA non-small cell lung cancer: segmentectomies result in significantly better cancer-related survival than wedge resections☆

Cited by 173 publications

References 17 publications

Sublobar resection for lung cancer

Sublobar resection for lung cancer

Tiny lung adenocarcinomas: better prognosis with a word of caution

Surgical strategies in the therapy of non-small cell lung cancer

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